Diagnosis Of Basal Cell Carcinoma Research Articles

Differential diagnosis of basal cell carcinoma by high-resolution ultrasound elastography.

The aim of this study was to assess the value of high-resolution ultrasonic quantitative parameters of shear wave elastography (SWE) in basal cell carcinoma (BCC). A total of 86 cases of BCC were enrolled as the case group, and 38 other similar skin pigmented lesions were randomly selected as the control group. Using pathological results as the gold standard, the diagnostic test method was used to evaluate the ability of high-frequency ultrasonic elastography to diagnose BCC, and the 2D ultrasonographic features, blood flow image characteristics, and SWE of BCC were summarized.

Reconstrução com autoenxerto de dorso nasal no tratamento de neoplasias cutâneas

ABSTRACT Basal cell carcinoma is the most common type among skin cancers. It occurs in basal cells and is primarily caused by sun exposure. It mainly affects elderly people, mainly man, in exposed areas of the body and is diagnosed through biopsy. The choice of treatment depends on the type, size, location and depth of penetration, the patient’s age, health conditions and potential aesthetic outcome. The present study aims to evidence, through a case report, the aesthetic and functional importance of the cutaneous transplant technique in cases of tissue loss in the face region by Basal cell carcinoma. A 56-year-old female patient, leukoderma, attended the Maxillofacial Surgery and Traumatology service of the Federal University of Pernambuco, complaining of asymmetry in the nasal dorsum region, with differentiated staining and raised edges. In anamnesis time she reported having suffered sun exposure for long periods. The patient underwent an incisional biopsy and subsequently, with a diagnosis of basal cell carcinoma, a resection of the lesion followed by skin autografting. Good acceptances of the skin flap as well as excellent aesthetic result were attained. The autogenous grafts use has shown satisfactory aesthetic results for remaining coverage after the lesion excision.

Diagnostic accuracy of basal cell carcinoma in dermatology setting in Serbia: A single-center study

Background/Aim. The growing incidence of skin tumors requires an accurate diagnosis. Dermoscopy, especially in vivo, enhances the diagnosis of basal cell carcinoma (BCC). Total body skin examination (TBSE), a visual inspection of the patient?s total body surface, is considered a basic step in the dermatological exam, especially in skin cancer screening. However, TBSE is still a matter of debate regarding its expediency in a real clinical setting. The aim of this study was to analyze the diagnostic accuracy of BCC detected and treated by referred dermatologists. Methods. The retrospective analysis included a five-year period of BCC detection during TBSE by visual inspection and dermoscopy. We calculated sensitivity, specificity and positive predictive value for BCC using histopathological results as the correct diagnosis. Results. Out of 3,346 biopsied skin tumors, 49.58% were malignant and 50.42% benign. The most common malignant tumor was BCC, accounting for 84.09%. Localization of BCCs was mainly on the trunk (38.92%) and the H-zone of the face (37.63%). Other localizations were face (non-H-zone) (6.67%), neck (3.01%), scalp (3.37%), arms (6.88%) and limbs (3.51%). Of all BCCs, 0.83% were recurrent BCC. The sensitivity for the diagnosis of BCC was 97.71%, and the positive predictive value was 95.08%. Conclusion. In the dermatology setting, TBSE and visual inspection with in vivo dermoscopy result in a very good diagnostic performance of BCC.

COVID-19 Pandemisinin Nonmelanom Deri Kanserleri Tanısı Üzerindeki Etkisi: Retrospektif Vaka Kontrol Çalışması

Objective: The coronavirus disease-2019 (COVID-19) pandemic has caused delays in the diagnosis and treatment of some oncological diseases. This study aimed to reveal the effect of the COVID-19 pandemic on the frequency of diagnosis of non-melanoma skin cancers (NMSC) and the demographic characteristics of patients. Material and Methods: Patients aged over 18 years, who were histopathologically diagnosed with basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) between March 12, 2019 and March 11, 2021 were included in the study. The demographic characteristics of these patients, the number of total skin biopsies, and the number of BCC and SCC biopsies were compared between the pre-pandemic and pandemic periods, based on the date of March 12, 2020, when the pandemic measures began to be implemented in Turkey. Results: With the pandemic, there was a 26.7% decrease in the total skin biopsies and a 21% decrease in the total NMSC biopsies. Despite a 34% decrease in the number of biopsies for the diagnosis of BCC, a 15.8% increase was observed in the number of biopsies for the diagnosis of SCC. The frequency of excisional biopsies was observed to increase among the patients with BCC and SCC during the pandemic period (p=0.004 and p=0.001, respectively). Conclusion: The number of total skin biopsies and total NMSC biopsies significantly decreased during the pandemic period. The health system should be reorganized to effectively handle pandemics and similar crisis periods, and new strategies should be determined regarding patient education, early diagnosis, and treatment approaches for NMSC.

Management of basal cell carcinoma with excision followed by rotation advancement flap

Background: Basal cell carcinoma (BCC) is the most common malignant skin tumor and is derived from pluripotent cells in the basal layer of the epidermis. One of the BCC management options is surgery followed by a skin flap to close the wound defect. Case Illustration : We present a 43-year-old woman with a major complaint of non-healing sores on the left zygomatic region, close to the medial canthus, with frequent episodes of bleeding and itching since one year before admission. The lesion was excised and followed by histopathological examination, which revealed the BCC diagnosis with tumor-free edges. Closure of the defect with a rotation advancement flap was performed with good results. Discussion : The diagnosis of BCC in this patient was based on history taking, dermatological and histopathological examination. According to the dermatological examination, the patient presented with superficial ulcers with hyperpigmented bases, irregular margins and raised edges, partly covered by crust in the left zygomatic region, consistent with typical clinical manifestation of BCC. Histopathological findings of BCC may vary according to the subtype. However, most cases of BCCs usually have similar histological characteristics. Conclusion : The functional and cosmetic result of BCC following excision and defect closure with rotation advancement flap yielded good results with a shorter healing time.   Keywords : basal cell carcinoma, excision, management, rotation advancement flap

Еfficiency of Basal Cell Diagnosis Skin Carcinomas Using Dermatoscopy in Combination with Ultrasound (Literature Review; Description of Clinical Cases)

Introduction. Basal cell carcinoma of the skin is the most common skin cancer in people with fair skin color. Early detection of basal cell carcinoma and proper surgical approach are crucial to reduce the incidence of this tumor. Visual examination is the first screening tool used by clinicians, but sometimes it is not enough to differentiate and determine treatment tactics. Therefore, non-invasive methods such as dermatoscopy and ultrasonography of the skin have recently become widely used, which provide a clear diagnosis, fully correlate with the pathomorphological diagnosis and allow determining the invasiveness of the process and the scope of surgery. The aim of the study. To establish the effectiveness of the diagnosis of basal cell carcinoma of the skin using dermatoscopy in combination with ultrasound, to clarify and justify the feasibility of using a double diagnostic test "Dermatoscopy + Ultrasound" in the diagnosis of skin tumors for future surgery. Materials and methods. Two cases of basal cell basal cell carcinoma in young patients with atypical localization, dermatoscopic and ultrasonographic parameters, correlation with pathomorphological diagnosis are described. Dermatoscopic parameters were evaluated according to G. Kittler's algorithm, skin ultrasound was performed on an expert class device "ACUSON Juniper Ultrasound System" with color and energy Doppler modes by a linear multifrequency transducer (5-17MHz) according to the original protocol developed by G.Alakhverdian. Results. A feature of the described clinical cases is the young age of patients (21 and 29 years), which is an atypical phenomenon in relation to the manifestations of BCC and indicates that recently basal cell carcinoma begins to occur at a young age and its typical location changes. The obtained data of dermatoscopic and ultrasonographic examination confirm specific clinical symptoms and are completely correlated with pathomorphological diagnosis. Conclusions. Dermatoscopy in combination with skin ultrasonography are reliable non-invasive techniques that allow real-time detection of clinical and subclinical lesions and should be used to diagnose and monitor for all skin cancers. Keywords: basal cell carcinoma of the skin, dermatoscopy, ultrasonography of the skin.

Novel PTCH1 and concurrent TP53 mutations in four patients with numerous non-syndromic basal cell carcinomas: The paradigm of oncogenic synergy.

There has been a significant increase in basal cell carcinoma (BCC) incidence, the most common cancer in humans and the age of presentation with the first diagnosis of BCC has decreased in past decades. In this study, we investigated the possibility of genetic markers that can lead to earlier and closer observation of patients at high risk for development of multiple BCCs. The overall goal is to decrease the morbidity and the economic burden of diagnosis and treatment of recurring and/or advanced BCCs. Four patients with numerous BCCs, some of them exceptionally large, were included in this study. A sample of representative BCCs, normal non-sun-exposed skin and blood samples were obtained from each patient. Whole-exome sequencing of DNA was conducted on all samples, and a series of bioinformatics filtering was performed to identify potentially pathogenic sequence variants. The analysis of the data resulted in detection of oncogenic mutations in PTCH1, two of which being novel, and concurrent mutations in TP53 in BCC tumours of all four patients. Such mutations may explain the numerous and postexcision recurring nature of the BCCs of exceptionally large size observed in all these patients, and they can be suggested to serve as a genetic marker for high-risk patients for early detection, prognostication and close follow-up.

Diagnostic Value of Optical Coherence Tomography Image Features for Diagnosis of Basal Cell Carcinoma.

Optical coherence tomography (OCT) is a non-invasive diagnostic method. Numerous morphological OCT features have been described for diagnosis of basal cell carcinoma (BCC). The aim of this study is to evaluate the diagnostic value of established OCT features and to explore whether the use of a small set of OCT features enables accurate discrimination between BCC and non-BCC lesions and between BCC subtypes. For each lesion, the presence or absence of specific OCT features was recorded. Histopathology was used as a gold standard. Diagnostic parameters were calculated for each OCT feature, and multivariate logistic regression analyses were performed to evaluate the loss in discriminative ability when using a small subset of OCT features instead of all features that are characteristic for BCC according to the literature. The results show that the use of a limited number of OCT features allows for good discrimination of superficial BCC from nonsuperficial BCC and non-BCC lesions. The prevalence of BCC was 75.3% (225/299) and the proposed diagnostic algorithm enabled detection of 97.8% of BCC lesions (220/225). Subtyping without the need for biopsy was possible in 132 of 299 patients (44%), with a predictive value for presence of superficial BCC of 84.3% vs 98.8% for presence of non-superficial BCC.

Epidemiology of basal cell carcinomas in the region of Amurel, Santa Catarina (SC), between 2009 and 2017. / Epidemiologia dos carcinomas basocelulares na região de Amurel, Santa catarina (SC), entre 2009 e 2017

Background: Basal cell carcinoma (BCC) is the most frequent skin neoplasm in Brazil, with increased incidence in the last decades. There are few studies from the Southern Region of Santa Catarina on the epidemiological profile of this tumor. Objectives: To establish epidemiological data on BCC in the Association of Municipalities of the Region of Laguna / SC (AMUREL). Methodology: An observational study with a cross-sectional analysis with positive anatomicopathological reports for BCC between 2009 and 2017 was carried out in a laboratory in Tubarão (SC). The variables collected were year of diagnosis, age, gender, city of origin, location of the lesion, histological subtype, lesion diameter and marginal compromise. Results: A total of 4,125 reports were identified, with a diagnosis of BCC in the AMUREL region with a predominance in men, with a higher frequency in the age group ranging from 61 to 80 years of age and located mainly in the encephalic and cervical regions, being the nodular subtype the most prevalent. A BCC incidence coefficient was found of 93.95 in 2009 and 161.86/100,000 inhabitants in 2017, resulting in an increase of 72%. Limitations of the study: The study was collected in only one laboratory in the stipulated region. Conclusions: A total of 4,125 people were diagnosed with BCC in the AMUREL region, with an incidence increase of 72% in 2009, when compared to 2017. In both genders, the sclerodermiform subtype had the highest frequency in relation to the marginal impairment. There was a prevalence of margins impaired after resection in 29% of the lesions, and a diameter ? 2 cm was the most found.

Combined PARP1-Targeted Nuclear Contrast and Reflectance Contrast Enhance Confocal Microscopic Detection of Basal Cell Carcinoma.

Reflectance confocal microscopy (RCM) with endogenous backscattered contrast can noninvasively image basal cell carcinomas (BCCs) in skin. However, BCCs present with high nuclear density, and the relatively weak backscattering from nuclei imposes a fundamental limit on contrast, detectability, and diagnostic accuracy. We investigated PARPi-FL, an exogenous nuclear poly(adenosine diphosphate ribose) polymerase (PARP1)-targeted fluorescent contrast agent, and fluorescence confocal microscopy toward improving BCC diagnosis. Methods: We tested PARP1 expression in 95 BCC tissues using immunohistochemistry, followed by PARPi-FL staining in 32 fresh surgical BCC specimens. The diagnostic accuracy of PARPi-FL contrast was evaluated in 83 surgical specimens. The optimal parameters for permeability of PARPi-FL through intact skin was tested ex vivo on 5 human skin specimens and invivo in 3 adult Yorkshire pigs. Results: We found significantly higher PARP1 expression and PARPi-FL binding in BCCs than in normal skin structures. Blinded reading of RCM-and-fluorescence confocal microscopy images by 2 experts demonstrated a higher diagnostic accuracy for BCCs with combined fluorescence and reflectance contrast than for RCM alone. Optimal parameters (time and concentration) for PARPi-FL transepidermal permeation through intact skin were successfully determined. Conclusion: Combined fluorescence and reflectance contrast may improve noninvasive BCC diagnosis with confocal microscopy.

High-Frequency Ultrasound and Shear Wave Elastography in Quantitative Differential Diagnosis of High-Risk and Low-Risk Basal Cell Carcinomas.

The purpose of this study was to investigate the value of high-frequency ultrasound and shear wave elastography (SWE) in quantitative differential diagnosis of high-risk and low-risk basal cell carcinomas (BCCs). A total of 52 BCCs confirmed by surgical pathology were studied. Taking pathologic subtypes as reference, all the cases were classified as high-risk BCCs or low-risk BCCs. High-frequency ultrasound parameters and SWE parameters recorded preoperatively were retrospectively analyzed. The differences of two groups were compared. There were 12 high-risk BCCs and 40 low-risk BCCs. The maximum infiltration depth (MID) and average Young's modulus (Eave ) of high-risk BCCs were 5.76± 2.56 mm and 31.61 ± 12.36 kPa, whereas of low-risk BCCs were 4.29± 1.77 mm and 20.04 ± 4.74 kPa, respectively, P< .05. The area under the receiver operator characteristic curve of MID and Eave were 0.714 and 0.811, P> .05. Taking 5.5 mm of MID and 24.45 kPa of Eave as the threshold for the diagnosis of high-risk BCCs, the sensitivity, specificity, and accuracy were 58.3%, 82.5%, 76.9% and 75.0%, 82.5%, 80.8%, P> .05. The MID and Eave of the lesion can be used to determine the recurrence risk of BCCs and provide a reference for the development of individualized treatment plans.

Machine-learning algorithm to predict multidisciplinary team treatment recommendations in the management of basal cell carcinoma

Basal cell carcinoma (BCC) is the most common human cancer. Facial BCCs most commonly occur on the nose and the management of these lesions is particularly complex, given the functional and complex implications of treatment. Multidisciplinary team (MDT) meetings are routinely held to integrate expertise from dermatologists, surgeons, oncologists, radiologists, pathologists and allied health professionals. The aim of this research was to develop a supervised machine-learning algorithm to predict MDT recommendations for nasal BCC to potentially reduce MDT caseload, provide automatic decision support and permit data audit in a health service context. The study population included all consecutive patients who were discussed at skin cancer-specialised MDT (SSMDT) with a diagnosis of nasal BCC between January 1, 2015 and December 31, 2015. We conducted analyses for gender, age, anatomical location, histological subtype, tumour size, tumour recurrence, anticoagulation, pacemaker, immunosuppressants and therapeutic modalities (Mohs surgery, conventional excision or radiotherapy). We used S-statistic computing language to develop a supervised machine-learning algorithm. We found that 37.5% of patients could be reliably predicted to be triaged to Mohs micrographic surgery (MMS), based on tumour location and age. Similarly, the choice of conventional treatment (surgical excision or radiotherapy) by the MDT could be reliably predicted based on the patient's age, tumour phenotype and lesion size. Accordingly, the algorithm reliably predicted the MDT decision outcome of 45.1% of nasal BCCs. Our study suggests that the machine-learning approach is a potentially useful tool for predicting MDT decisions for MMS vs conventional surgery or radiotherapy for a significant group of patients. We suggest that utilising this algorithm gives the MDT more time to consider more complex patients, where multiple factors, including recurrence, financial costs and cosmetic outcome, contribute to the final decision, but cannot be reliably predicted to determine that outcome. This approach has the potential to reduce the burden and improve the efficiency of the specialist skin MDT and, in turn, improve patient care, reduce waiting times and reduce the financial burden. Such an algorithm would need to be updated regularly to take into account any changes in patient referral patterns, treatment options or local clinical expertise. lPLAS_20-21_A08.

Erythropoetin and erythropoetin receptor systems, and oxidative status in patients with basal cell.

Erythropoietin (Epo) controls a variety of signal transduction pathways during oxidative stress. The main function of Epo and its receptor (EpoR) is the stimulation of erythropoiesis. The role of Epo and EpoR on non-hematopoietic normal and cancerous tissues is still poorly understood. This is the first report in which we aimed to investigate the role of Epo and EpoR systems at oxidative condition in human basal cell carcinoma (BCC), which is the most common tumour in the world.Materials and methods: Fresh normal and cancerous skin paired tissue was obtained from 63 patients who underwent curative BCC resection in Kahramanmaras, Turkey. Preliminary diagnosis of BCC was made in the dermatology clinic by excision and then the diagnosis was confirmed as histopathologic findings. Oxidative stress biomarkers such as superoxide dismutase (SOD) and catalase (CAT) activities, and malondialdehyde (MDA) levels in biopsy samples were measured spectrophotometrically, and also the levels of Epo and EpoR were measured by ELISA. While the levels of MDA in cancerous tissue of patients with skin BCC were significantly higher than normal neighbouring skin tissue (p<0.05), SOD and CAT activities decreased (p<0.05). Furthermore, a remarkable increase was found in the Epo level ofpatients with skin BCC in comparison with the normal neighbouring skin tissue (p<0.05). However, we found that EpoR levels decreased (p<0.05). Results indicate that there is an active oxidative process in BCC biopsies. The levels of increased Epo and decreased EpoR in oxidative condition due to hypoxia may aggravate tumour growth by its angiogenic activity.

Immunohistochemical Expression of CK19, AR, PHLDA1, CD10 and Ki67 in the Differentiation between Trichoepithelioma and Basal Cell Carcinoma: A Systematic Review

Background. Basal cell carcinoma (BCC) and trichoepithelioma (TE) are follicular adnexal neoplasms that arise from the follicular germ but with divergent biological behavior. The gold standard in the differentiation is through histopathological examination using hematoxylin and eosin (H and E) stain. There are cases, however, when the distinction is not straightforward.&#x0D; Objective. To assess the association and diagnostic accuracy of the immunohistochemical (IHC) expressions of CD10, Ki67, CK19, androgen receptor (AR), and PHLDA1 in distinguishing between basal cell carcinoma and trichoepithelioma.&#x0D; Methods. We conducted a comprehensive search on cross-sectional studies on human tissue from 2000 to 2020 in MEDLINE (PubMed), CENTRAL and EMBASE for comparative studies and reference lists. The data were summarized and analyzed using Microsoft Excel and RevMan. We used Chi-square test for independence, summary receiver operator curves (sROC), and diagnostic odds ratio (OR).&#x0D; Results. We included 15 articles containing 686 BCC and 367 TE in the systematic review. The pooled staining of biomarkers showed a significant difference in the staining of CK19 (p&lt;0.05) and AR (p&lt;0.0001), and PHLDA1 (p&lt;0.0001). Diagnostic odds ratio was used to confirm these associations. AR was found to have the highest odds in the diagnosis of BCC (OR 27.92, 95% CI 10.69, 72.86). The pattern of staining of CD10 is significant (p&lt;0.001) with staining of both tumor and stroma (OR 8.09, 95% CI 4.57, 13.53) and staining of tumor alone (OR 8.15, 95% CI 4.56, 14.35) (p&lt;0.001) in the diagnosis of BCC. CD10 stromal staining, on the other hand, is significantly associated with the diagnosis of TE (OR 7.26, 95% CI 5.06, 10.44) (p&lt;0.0001). There is no significant association between Ki67 staining (OR 1.22, 95% CI 0.48, 3.09) (p=0.67) and the diagnosis of BCC. The forest plot and sROC showed that AR had high specificity across all included studies in the diagnosis of basal cell carcinoma, while PHLDA1 demonstrated high specificity and high sensitivity in diagnosing trichoepithelioma.&#x0D; Conclusion. The biomarkers AR and PHLDA1 are useful as an initial panel to distinguish between BCC and TE, given that both showed high sensitivity as well as significant association with BCC and TE respectively. CD10 and CK19 may also be used with AR and PHLDA1 for further confirmation.

LB769 A report of Basal Cell Carcinoma hospitalizations: An analysis from the national inpatient sample database

There is a scarcity of national population studies on hospitalizations of Basal cell carcinoma (BCC) patients in the United States (U.S). This study aims to compare comorbidities of BCC to non-BCC hospitalizations and determine the most common reasons for BCC hospitalizations resulting in inpatient mortality. Data were obtained from the National Inpatient Sample (NIS) 2016-2018 databases, which contained about 105 million hospitalizations. The NIS is the largest inpatient database in the U.S. We abstracted data for adult hospitalizations, with any diagnosis of BCC, using ICD-10 codes.

Traitement par chimiothérapie orale (sonidegib) de carcinomes basocellulaires étendus, à propos de 4 cas

Basal cell carcinoma (BCC) is the most frequent cutaneous carcinoma. Its incidence is constantly increasing, primarily due to sun exposure during the two first decades of life. The lower lid and medial canthus are the most common locations. In the majority of cases, surgery with sufficient margins is the first-line treatment. In the case of inoperable tumors (extensive lesions, poor general health, high surgical morbidity, unacceptable cosmetic sequelae), oral chemotherapy can be suggested. We report the follow-up of 4 patients with advanced non-metastatic basal cell carcinoma (BCC) treated with oral chemotherapy (sonigegib). All patients were female with a mean age of 80years. The first patient had an infiltrative BCC of the right lower lid with orbital invasion, the second a nodular BCC of the right inferior lid with massive cutaneous and orbital invasion extending to the controlateral medial canthal angle, the third an advanced infiltrative BCC invading both orbits and nasal cavities, and the fourth, an infiltrative BCC with extension to the ipsilateral skin of the face. The diagnosis of BCC was confirmed by multiple biopsies in our four patients prior to starting chemotherapy. Because of the locally advanced lesions, surgery was contraindicated in all cases, chemotherapy was undertaken (sonidegib 200mg daily), and ophthalmological and dermatological examinations were performed every 3months. In all 4 patients, the outcome was very favorable, with one clear regression in tumor size and infiltration and 3 partial regressions. Many side effects were noted, including nausea, muscle cramping, dysgeusia resulting in significant weight loss, and malnutrition in the elderly patients. The treatment had to be discontinued after 11months in the patient with total macroscopic regression because of major side effects. The treatment is still underway for the other patients and will be continued as long as a clinical benefit is observed. The treatment will be discontinued if intolerable side effects develop. Oral chemotherapy (sonidegib) is an effective alternative treatment when surgery cannot be realized, especially in the case of extensive infiltrative non-metastatic BCC.

Multiple non-syndromic basal cell carcinoma with the chest as primary site and lung metastases: A rare case.

Basal cell carcinoma (BCC) is the most commonly diagnosed cancer in humans, usually affecting elderly Caucasian men and skin regions mostly exposed to the sun, that rarely metastasizes. We report an unusual and aggressive case of multiple, non-syndromic metastatic BCC with an uncommon primary site in the chest and pulmonary metastases, treated successfully with surgery and vismodegib. A 51-year-old woman presented with a large pigmentary lesion of the chest, close to the sternum. She had the lesion for > 25 years and lately noticed multiple facial lesions. The diagnosis of multiple BCC was suspected and a punch biopsy of the primary lesion was performed. Diagnosis was confirmed by immunohistochemistry (BerEp4+, EMA− phenotype). After excision, staging with a thorax computed tomography scan revealed metastatic micro-nodules in the left lung, confirmed histologically after video-assisted thoracic surgical biopsy. Adjuvant chemotherapy with vismodegib was proposed and administered. At 30 days follow-up, thorax computed tomography scan was unaltered and her facial lesions showed significant regression. Although prognosis remains poor, early diagnosis and prompt management complimented by novel biological agents, like vismodegib, targeting disease pathogenesis, seems to bring promising results.

Deep Learning for Basal Cell Carcinoma Detection for Reflectance Confocal Microscopy

Basal cell carcinoma (BCC) is the most common skin cancer, with over 2 million cases diagnosed annually in the United States. Conventionally, BCC is diagnosed by naked eye examination and dermoscopy. Suspicious lesions are either removed or biopsied for histopathological confirmation, thus lowering the specificity of noninvasive BCC diagnosis. Recently, reflectance confocal microscopy, a noninvasive diagnostic technique that can image skin lesions at cellular level resolution, has shown to improve specificity in BCC diagnosis and reduced the number needed to biopsy by 2-3 times. In this study, we developed and evaluated a deep learning-based artificial intelligence model to automatically detect BCC in reflectance confocal microscopy images. The proposed model achieved an area under the curve for the receiver operator characteristic curve of 89.7% (stack level) and 88.3% (lesion level), a performance on par with that of reflectance confocal microscopy experts. Furthermore, the model achieved an area under the curve of 86.1% on a held-out test set from international collaborators, demonstrating the reproducibility and generalizability of the proposed automated diagnostic approach. These results provide a clear indication that the clinical deployment of decision support systems for the detection of BCC in reflectance confocal microscopy images has the potential for optimizing the evaluation and diagnosis of patients with skin cancer.

Whole‑genome identification and systematic analysis of lncRNA‑mRNA co‑expression profiles in patients with cutaneous basal cell carcinoma.

Cutaneous basal cell carcinoma (BCC) is a common subtype of malignant skin tumor with low invasiveness. Early diagnosis and treatment of BCC and the identification of specific biomarkers are particularly urgent. Long non-coding RNAs (lncRNAs) have been shown to be associated with the development of various tumors, including BCC. The present study conducted a comparative analysis of the differential expression of lncRNAs and mRNAs through whole-genome technology. Microarray analyses were used to identify differentially expressed (DE) lncRNAs and DE mRNAs. Reverse transcription-quantitative (RT-q) PCR confirmed the differential expression of 10 lncRNAs in BCC. Subsequently, a lncRNA-mRNA co-expression network was constructed using the top 10 DE lncRNAs. Finally, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were performed to investigate the possible biological effects of the identified mRNAs and to speculate on the possible biological effects of the lncRNAs. A total of 1,838 DE lncRNAs and 2,010 DE mRNAs were identified and 10 of the DE lncRNAs were confirmed by RT-qPCR. A lncRNA-mRNA co-expression network comprising 166 specific co-expressed lncRNAs and mRNAs was constructed using the top 10 DE lncRNAs. According to the results of the GO and KEGG analyses, lncRNA XR_428612.1 may serve an important role in mitochondrial dysfunction and the progression of BCC by modulating TICAM1, USMG5, COX7A2, FBXO10, ATP5E and TIMM8B. The present study provided whole-genome identification and a systematic analysis of lncRNA-mRNA co-expression profiles in BCC.

Basal cell carcinoma in a 14-year-old: A rare case of a common skin cancer

Background:&nbsp; Basal cell carcinoma (BCC) is the most common cutaneous malignancy. It usually arises in sun-exposed areas of the body, with the face and neck being the most common sites for BCC. BCC is typically found in older individuals, but it is becoming more prevalent in people younger than 50. However, such cases in children under 15 are rarely encountered. Pigmented BCC is a common presentation in people of color, while such presentation is relatively unusual in Caucasians. Pediatric cases could be idiopathic, but it is more commonly associated with a genetic defect, such as basal cell nevus syndrome, xeroderma pigmentosum, Bazex syndrome, and albinism. Those cases could also arise from a congenital lesion, e.g., nevus sebaceous, radiotherapy-related, or solid organ transplant.&nbsp; Case Illustration: We present the case of a 14-year-old boy with a chief complaint of growing tumor on the left cheek since he was 8 years old. He was diagnosed with childhood-onset BCC based on the findings of dermoscopy and skin biopsy. The patient underwent surgical excision of the lesion with 3 mm margins and a full-thickness skin graft obtained from the left retroauricular area.&nbsp; Discussion: Removal of the tumor with clear margins remains the gold standard for BCC treatment. This case presentation showed the best practice for BCC cases in the childhood population.&nbsp; &nbsp; Conclusion: The diagnosis of BCC should not be neglected in the childhood population.&nbsp;&nbsp; &nbsp; Keywords : idiopathic BCC, childhood, excision&nbsp;